Until It Is Enough: Conversations about Shiurim for Yom Kippur 

 

Sarah Osborne

…[On Yom Kippur] an ill person – we feed him according to the word of experts. And if there are no experts there – we feed him according to his own word, until he says “[it is] enough.”
– Mishnah Yoma 8:5^[1]

I can still picture where I was standing when he said it. We were chatting about my work for A Mitzvah to Eat, focusing on the resources and support we provide to those unable to safely fast.

“I know about this topic,” he said. “If you can’t fast, there’s a way that you have to eat^[2] on Yom Kippur.^[3] I forget the amounts and the timing, but I remember that you have to eat in shiurim.”^[4] 

I remember this conversation not because it is unique, but because it isn’t.

Sitting next to that memory is a conversation I had with a rabbi. He told me that he advises shiurim to everyone unable to safely fast, because shiurim are the only way to eat on Yom Kippur that is not halakhically problematic.

But that’s not all. There are also websites, articles, and social media posts stating that everyone who is unable to safely fast on Yom Kippur should (try to) eat in shiurim. These statements sometimes say that shiurim “minimize the transgression” of eating on Yom Kippur.^[5] This language may send the message that, for those who cannot safely fast, eating as usual^[6] or in larger amounts than shiurim is a transgression – a sin or wrongdoing.

To ensure that people only fast when it is safe to do so, it is crucial to reflect on this messaging. To that end, it is imperative to convey that when fasting is considered unsafe,^[7] eating on Yom Kippur is a religious obligation. When we speak about shiurim, we must echo this framing. Otherwise, we can send an implicit message that one should eat in shiurim even in cases where they are unsafe and insufficient.

To help you understand what I mean, I will share narratives that show the complexities and dangers in much of our current messaging around shiurim. After that, I will review halakhic texts to demonstrate how they frame shiurim. Then, I will offer alternative language for our conversations about shiurim. This piece closes with additional guidance.

Narratives about Shiurim
Let’s begin by considering some personal experiences around shiurim. Over the past few years, I have spoken to many community members and rabbis.^[8] I am grateful to those who volunteered to share their stories and perspectives for this piece.^[9] I will be sharing their experiences with you. But first, I will start with my own.

Until It Was Enough
My own connection to shiurim comes from a deeply personal place. Fasting is unsafe for me because I have trauma around food and hunger. While this kind of trauma can come from different kinds of experiences, mine comes from surviving many years of abuse.^[10]

When I began to experience trauma symptoms on fast days, I was terrified. I had heard that in order to eat on Yom Kippur, I needed to be in clear and immediate danger, but this danger felt amorphous. Looking to rabbis^[11] for guidance was not a smooth process. Two different rabbis^[12] advised me to keep trying to fast. I now consider their guidance unsafe.

After three more years of fasting, I finally got the courage to ask again. I spoke to a rabbi who said that I had a mitzvah to eat on Yom Kippur. When I asked about shiurim, that rabbi  encouraged me to eat as usual, without limits. For me, eating in a way that was safe and sufficient meant eating the foods that I normally needed to feel fully nourished. That was exactly what I needed – to eat until I felt that it was enough. 

Even as Someone Who Had Recovered
Melissa had a very different experience. She spoke to a rabbi about her concerns regarding fasting on Yom Kippur. She told him that she was prone to fainting, that she had a history of anorexia, and that she was pregnant.  The rabbi advised her to eat in shiurim.

Melissa told me, “Some people say once you are recovered [from an eating disorder], it’s okay [to eat in shiurim].” But eating in shiurim made her feel ill. She shared, “One year I was told to do shiurim, and I was triggered. I went into an anorexia spiral for a week…even as someone who was considered therapeutically and medically recovered.” Melissa emphasized her point, saying, “I do not think that it is safe for someone with an eating disorder history to do shiurim.”

Worrying that I’d Had Too Much
Maya was advised by a rabbi to eat in shiurim, but she still faced concerning symptoms on Yom Kippur itself. When she became frightened about potential danger, she found herself unable to switch from shiurim to eating what was necessary for her safety. She observed, “At that point, I didn’t have the confidence to say, ‘This isn’t working. I need to eat properly.’” Rather, Maya kept to her rabbi’s instructions, thinking, “I have to do exactly what the rabbi said, and he said that I have to do shiurim.”

Maya shared that one rabbi framed shiurim as being “as if you’re fasting, but having more is breaking the fast.” He was also not clear on the amounts for shiurim, so Maya minimized her eating to avoid ‘breaking the fast.’ Several years later, when a different rabbi gave her a list specifying how much food could fit within the shiurim amounts, she was surprised. She remembers thinking, “Oh! That much is a shiur?! I was eating a third of that, or half of that, or a quarter of that, and worrying that I’d had too much.”

Only if It Is Healthy for Me
Shifra shared that she has Type 1 diabetes. When her doctors said that fasting was not safe for her, she and her father (who is a rabbi) discussed options for eating on Yom Kippur. Shifra noted, “[Conversations around shiurim were] always very much worded in my family as ‘if it works,’ but outside [of my family] it was more, ‘This is what needs to happen’ [or] ‘the only option.’”

While shiurim have been sufficient to prevent danger from fasting (she does sometimes reduce the drink time increment, as suggested by some halakhic opinions, to get enough fluids), Shifra also voiced some concerns about shiurim. She spoke about societal messaging around food and body size, which often idealizes eating small portions or limiting the amount of food one eats, for the purpose of weight loss and thinness. She said, “I sometimes find [myself] think[ing] that I should limit my food intake, [and] shiurim is timing and limiting your food intake…There was even a year where I found that I tried to somewhat continue the sparse eating the day after [Yom Kippur].”

Eating in shiurim on Yom Kippur was not safe for Shifra’s mental health that year. Once she began timing and measuring her eating on Yom Kippur, it felt natural to continue eating in that way afterwards. While Shifra was able to return to eating as usual, she now thinks differently about eating in shiurim on Yom Kippur. Each year, she checks in with herself and her mental health in the time leading up to Yom Kippur, to see whether shiurim will be safe and sufficient. Because of that process of self-reflection, Shifra now frames eating in shiurim as “only for Yom Kippur itself, and only if it is healthy for me.”

It’s the Way that I Can “Fast”
Ateret’s experience brings a different perspective. She spoke to a rabbi after fasting triggered a severe migraine that caused ongoing symptoms. Her rabbi advised her to try shiurim on Yom Kippur.

For Ateret,  3-4 shiurim over the course of the entire day were enough to prevent concerning symptoms. As she explained, “For me, shiurim are absolutely safe and sufficient. I often compare it to getting extra time on an exam; it’s the way that I can ‘fast’ with the baseline of someone who is able to fast.”  For Ateret, shiurim were enough to meet her needs on Yom Kippur. She also found shiurim to be meaningful and aligned with the feeling of the fast day.

About the Interviews
Let’s reflect on these accounts. I cannot safely eat in shiurim due to trauma; the message that I had a mitzvah to eat as usual, without limits, enabled me to have a safe experience on Yom Kippur. Meanwhile, even though her rabbi knew that she had a history of anorexia, Melissa was advised to eat in shiurim, without any hesitation or encouragement to first consult with a health professional. Unfortunately, shiurim were not safe for Melissa. Rather, they increased danger by triggering a life-threatening illness.

Maya’s rabbi did not mention that shiurim may not be sufficient, or that she should trust her judgment if she suspected she needed to eat more. Her rabbi’s emphasis was on not breaking the fast, suggesting that eating more than shiurim, even when needed for her safety, would be a transgression. Shifra was taught that shiurim are only appropriate if they are enough for her. While shiurim interplayed with societal messaging about food restriction, which is potentially dangerous, she was empowered to only use shiurim in the future when they are both safe and sufficient for her. Ateret’s story is the one story where shiurim were successful and uncomplicated.

There is clearly much complexity around the topic of shiurim. For some people, shiurim are safe and sufficient while also enabling them to fulfill the mitzvah of affliction (inui) on Yom Kippur.^[13] Additionally, some people who are unable to safely fast wish that they could still fast. When shiurim are safe and sufficient, they offer a chance to more closely emulate the feeling of fasting.

But that is not the full picture. For some people who are unable to safely fast, shiurim are concerning or unsafe. Additionally, language around ‘minimizing transgression’ and eating as little as possible on Yom Kippur may make it difficult for those unable to safely fast to feel comfortable with eating in a manner that is safe and sufficient for them.

These diverse needs around shiurim present a challenge. How can we make sure that shiurim are only used when they are safe and sufficient, and not a moment longer? In our conversations, how can we acknowledge and balance the varying needs of those who are not safely able to fast?

To answer these questions, let’s look at a selection^[14] of halakhic texts. These texts will guide us in speaking about shiurim with more nuance.

Reading the Halakhic Sources
The halakhic texts will make it clear that shiurim were only intended to be used when they would be safe and sufficient. While that may seem obvious to some, this crucial point is often omitted from conversations on this topic. Therefore, whether you are already familiar with these texts or you are encountering them for the first time, it is important to read (or perhaps reread) them with a focus on the nuance and language they use.

The first text to discuss shiurim with respect to Yom Kippur is the Mishnah (Yoma 8:2). This text defines the amounts for a shiur, the quantity and manner of eating that shiurim are intended to be less than:

[On Yom Kippur,] one who eats a large date-bulk of food, equivalent to a date and its pit, or who drinks a cheekful of liquid, is liable [to receive the punishment of kareit]. All of the foods join together to constitute a date-bulk. All of the liquids join together to constitute a cheekful. [However] if one eats and drinks, the food and liquid amounts do not join together.^[15]

Three mishnayot later (Yoma 8:5), the Mishnah makes it clear that, like most mitzvot in the Torah, the punishment (kareit, in this case) only applies to a person who is obligated in this fast, but does not apply to a person who is unable to safely fast:

[On Yom Kippur,] a pregnant woman who smelled [food and needed to eat it^[16]] – we feed her until she recovers herself. An ill person  – we feed him^[17] according to the word of experts. And if there are no experts there –
        we feed him according to his own word
        until he says [“it is] enough.”^[18]

This mishnah refers to meeting the eating and drinking needs of the sick (holeh)^[19] until that person says it is enough. What does that mean? The only explanation I have found is from Rambam,^[20] who says the holeh eats until they feel satiated. Personally, I always understood this text to mean eating enough to avert danger from fasting, but, upon further study, I have been unable to find a source for this reading.

Looking back at the mishnah, the phrasing about the sick person who eats until he says it is enough parallels the language about the pregnant woman who eats until she recovers herself. It seems that the mishnah takes a holistic approach to addressing each individual’s physical and mental health needs. In the mishnah’s language, we see care for two issues. First, the mishnah is concerned with safety, meaning that the way that one observes Yom Kippur, whether through fasting or eating (because fasting is unsafe), should not endanger them. Second, the food that the person eats should feel sufficient for them. From here on out, I will use the phrase ‘safe and sufficient’ for this expansive understanding of the mishnah’s words, ‘until he says that it is enough.

The Babylonian Talmud (Yoma 83a) expands upon this mishnah, framing an ill person’s eating on Yom Kippur as follows:

We learned in the mishnah: If there are no experts present [to determine whether an ill person needs to eat], one feeds him on his own word. The reason [stated for feeding him on his own word] is that there are no experts present, [implying that] if experts were present, one would not [listen to the ill person]! [No,] this is what it means: For what cases is [consulting with an expert] prescribed? When [the ill person] says, “I do not need [to eat].” But if he says, “I do need [to eat],” there is no role for experts at all – one feeds him on his own word, as it is stated: “The heart knows its own bitterness.” (Proverbs 14:10)^[21]

While the Mishnah prioritizes expert advice when present, the Gemara emphasizes that lived experience is just as significant. To ensure that it is safe to fast on Yom Kippur, we err on the side of caution. If either the expert or the individual thinks they need to eat, then the person must eat.

This gemara’s primary concern is safety. Additionally, there is no language here about eating in shiurim^[22] or minimizing transgression. The latter idea seems, for some people, to emerge from Yoma 82a, referring to a pregnant woman who had a craving for forbidden food. Denying her that need was considered unsafe: 

The Sages taught in a baraita: With regard to a pregnant woman who smelled consecrated meat or pig meat – one inserts a thin reed into the juice [of that item] and places it on her mouth. If her mind becomes settled with that, it is well. And if not, she is fed the gravy itself. If her mind becomes settled, it is well. And if not, she is fed the fat of the forbidden food itself, as there is no halakhah that stands in the way of saving a life except for the prohibitions against idol worship, and forbidden sexual relationships, and bloodshed.^[23]

While I have heard some people describe this text as an example of ‘minimizing transgression,’ let’s remember that the woman who is centered in this text is in danger. She is required to eat what she needs for her safety so there is no transgression. The rabbis preferred not to permit beyond what was needed, and advised starting small as long as it was deemed to be safe. The language found in halakhic works on this issue is le-ma’et et ha-issur, limiting the prohibition that is permitted in this case. The language is not about limiting transgression.

In conversations about the above gemara and the words ‘minimizing transgression,’ I have noticed an interesting phenomenon. Some of my contacts frequently use the phrasing of ‘minimizing transgression’ in halakhic conversations about meeting health and safety needs. However, other contacts had never encountered this phrasing and wondered where I had even heard or seen it. In investigating, I suspect that the issue may be an imprecise English translation. For example, when R. Melamed writes in Hebrew about shiurim^[24], he states: 

When, according to a physician’s instructions, a dangerously ill person does not urgently need to eat and drink in greater quantities, some Rishonim wrote that it is preferable for him to drink and eat with pauses, in small amounts less than a shiur, in order to lessen the level of the prohibition.

כאשר על פי ההוראה הרפואית החולה המסוכן אינו חייב לשתות ולאכול בדחיפות כמות גדולה, כתבו כמה מגדולי הראשונים שעדיף שישתה ויאכל בהפסקות פחות פחות מכשיעור, כדי למעט באיסור.

In contrast, on Rav Melamed’s Jewish Tradition website,^[25] the English text reads, “What if the doctor determines that fasting would put a person’s life at risk, but that eating or drinking large amounts is not necessary? In such a case some halakhic authorities say it is preferable to eat or drink small amounts periodically to minimize the transgression.”

Please note that lessening or minimizing the level of prohibition (that due to safety concerns is now permitted) has a different meaning than minimizing transgression. The word ‘transgression’ suggests that the act remains a wrongdoing or sin; a transgression is what happens when a person does a prohibited action. People who cannot safely fast are not only permitted to eat on Yom Kippur, but are also required to do so. Therefore, there is no transgression to minimize.

While the Talmud does reference the concept of starting small as long as it is deemed to be safe and sufficient, it is only in the time of the Rishonim that we find this concept applied to a holeh who needs to eat on Yom Kippur. Some Rishonim, such as Tur,^[26] mention feeding a holeh in shiurim when shiurim will be safe and sufficient. Still, other Rishonim^[27] omit this idea and simply emphasize the requirement that the eating be enough for the ill person.

Shulhan Arukh (Orah Hayyim 618:7-8) rules:

[On Yom Kippur], when we feed pregnant women or an ill person,^[28] we feed them little by little, so that [the food] will not combine to a shiur. Therefore, we feed him an amount the size of two-thirds of a medium sized egg and wait as long as it takes to eat four eggs.

With liquids, they should check with the ill person himself, and see how much, when it is moved to one side [of his mouth], looks like he has a cheekful.

They should give him less to drink than that shiur and wait between each drink and the next for as long as it would take to eat four eggs. Or, at least, wait between each drink long enough to drink the volume of a revi’it.

And if they evaluate that these shiurim are not enough for him, or if the ill person says so, or they are unsure [whether it is enough], we give him food and drink as much as he needs (immediately).^[29]

After fully describing shiurim,^[30] Shulhan Arukh emphasizes that they are only for those who would find them to be enough.

Notably, this Shulhan Arukh text is often used, amongst other halakhic texts, to suggest that everyone unable to safely fast should eat in shiurim. However, that read of Shulhan Arukh removes the nuance of this halakhic position. Shiurim should be used if, and only if, they have first been determined to be safe and sufficient for that person. Additionally, if at any point during the fast shiurim are not enough, larger amounts must be started immediately.

In Arukh Ha-Shulhan, Rabbi Yechiel Michel Epstein echoes and strengthens this language. First he references Tur and Shulhan Arukh,^[31] and describes the amounts and manner of eating in shiurim. But then he adds:

And it is obvious that all of this is only for a situation where it is enough for the ill person. But if they evaluate that he needs a lot at one time, or if the ill person says so, or if they are uncertain if this will be enough for him, they feed him whatever he needs, and give him whatever he needs to drink, without exacting [measurements].^[32]

Here, Arukh Ha-Shulhan stresses that shiurim should only be used on Yom Kippur if they are enough for the ill person. If shiurim are not safe and sufficient, or we are uncertain, we feed that person as much as they need. Arukh Ha-Shulhan emphasizes the importance and individuality of each ill person’s own needs. He adds that there are even health conditions whose healing process consists of eating larger amounts than shiurim^[33] and that these needs should be met fully.^[34]

Rav Hayyim of Brisk offers another perspective on shiurim. In Halakhic Man,^[35] Rabbi Joseph B. Soloveitchik writes:

My grandfather, R. Hayyim of Brisk, disagreed with the legal view that on the Day of Atonement one feeds a sick person who is in danger [of dying] small amounts of food at a time, each amount less than the forbidden measure of food for that day. Rather, he instructed those who were taking care of a sick individual to serve him a regular meal, just as they would on other days.

In Hidushei Ha-Griz on the Rambam,^[36] Rabbi Y.Z. Soloveitchik (Rav Hayyim’s son and R. Joseph B. Soloveitchik’s uncle) writes that Rav Hayyim distinguished between two categories. One who was already dangerously ill should eat as usual, with the reasoning that eating as usual supports healing more than shiurim do. However, one not yet dangerously ill should eat preventatively in shiurim if their doctor^[37] thought that fasting could worsen their illness and possibly put them in danger.

I appreciate Rav Hayyim’s approach, but I disagree with positions that assert that any broad category of people can safely eat in shiurim. Rather, before a person eats in shiurim, whether preventatively or not, we must be sure that shiurim will be safe and sufficient for their needs. We must also communicate to that person that if shiurim are no longer safe and sufficient during the course of the fast day, that eating in greater amounts, or as usual, would be a religious obligation.

R. Melamed also writes extensively about shiurim. He limits them to circumstances when a doctor has said that the dangerously ill person does not need to urgently eat or drink in large amounts.^[38] Then, he adds:

However, if there is any concern that eating and drinking in shiurim will cause at-risk patients to neglect the recovery of their strength, they must eat and drink normally. For example, if a postpartum woman is exhausted, it is better that she drink normally so that she can have uninterrupted sleep than that she stay awake to drink small quantities intermittently.

Likewise, diabetics whose condition has no stable treatment must be very cautious. If there is concern that eating and drinking le-shiurim will lead them to be neglectful and not eat as much as they need, they should eat normally.^[39]

R. Melamed raises and answers a number of important questions. For example, what manner of eating would most help a person who needs to eat on Yom Kippur to get the sleep they need? Does focusing on the small amounts and timing of shiurim make it harder to eat as much as is needed? How do we meet the communal needs of those who are unable to safely fast? These are important questions to consider.

Let’s be mindful, however, when we name one particular health condition, because the intention here is not clear. Is R. Melamed saying that only people with diabetes without stable treatments should eat as usual if there is concern about shiurim not being enough? What about other people who are dangerously ill with no stable treatment? Surely they also risk potentially not eating enough when eating in shiurim. To ensure that shiurim are only used when safe and sufficient, it is important to emphasize that any person who will not be able to eat enough or to get what they need from shiurim has a mitzvah to eat in greater amounts or as usual.

To conclude our look at the sources, let’s remember how we began. We looked at these texts because the narratives showed the need for nuance when speaking about shiurim. But what are some specific ways that we can change our conversations to reflect that nuance? In this next section, I will offer some suggestions.

Better for Whom?
Halakhic conversations often involve statements of what is halakhically better or more preferable. In the case of shiurim, it is important to include the context that halakhic authorities such as Shulhan Arukh and Arukh Ha-Shulhan found necessary – shiurim are only “preferable” if they are clearly safe and sufficient for that person.

When we use this language on social media, articles, and conversations, it is crucial that we qualify our phrasing. We must always answer the question, “Better for whom?” For example, if we wish to say that shiurim are halakhically preferable, we should explicitly say for whom that is the case: those who would find shiurim to be enough for them. This concept can be used in conjunction with other fast day discussions as well. For example, if you wish to write that on Yom Kippur it is better to only drink than to eat and drink, it is important to say for whom that is the case: one for whom drinking only is safe and sufficient.

When Possible
Next, let’s discuss this common phrasing: “When possible, those who cannot safely fast should try to eat in shiurim.” When I read a sentence like this, the intention is difficult to discern. Does the phrase ‘when possible’ mean that one who cannot safely fast should push themselves to eat in shiurim even if shiurim are not enough for that person? It certainly is possible for one who cannot safely fast or eat in shiurim to do so anyway, though it may result in hospitalization, extended illness, or ongoing suffering.

We must change our language to offer more clarity. Instead of language like ‘when possible,’ we might say ‘When safe and sufficient.’ We should also encourage conversations with health professionals for those who are uncertain whether shiurim will be safe and sufficient.

Minimize Transgression
Lastly, let’s address the wording of ‘minimize transgression.’ While some of my contacts use this phrasing in halakhic conversations about meeting health needs, other contacts have never heard it. As I discussed earlier, I suspect that this phrase emerges from an imprecise English translation. As a reminder, those unable to safely fast are permitted and even required to eat on Yom Kippur. They are certainly not transgressing. Therefore, I urge replacing implicit or explicit messages of ‘minimizing your transgression’ with a different framing, one which would not imply, even accidentally, that eating on Yom Kippur is a transgression for those who cannot safely fast.

In a recent conversation with Rabbanit Debbie Zimmerman, Director of Matan’s online Shayla responsa program, she suggested the following framing for rabbis and halakhic advisors: “When fasting is unsafe and eating is permitted, the primary concern should be convincing the individual to eat on Yom Kippur for their safety, rather than convincing them to eat in shiurim. Once they have been convinced [that] they can or must eat whatever is necessary to ensure their safety, then there is room for discussing whether shiurim will be sufficient.”

I echo Rabbanit Zimmerman’s framing and suggest that those unable to safely fast determine, through self-reflection and conversations with health care professionals, whether they have several options for how to safely eat and/or drink on Yom Kippur, or whether they need to eat as usual. Where there are several safe and sufficient options, rabbis can advise which is halakhically preferable as a starting place. In these conversations, it is important to instruct community members that if the initial plan becomes unsafe or insufficient during the course of the fast,  it is a mitzvah to eat and drink in larger amounts or as usual immediately, when needed for one’s safety.

Final Thoughts
We began by considering narratives about shiurim. In reading about these personal experiences, we saw that shiurim could be enough for some people, some of the time, working best for those who had limited eating and drinking needs on Yom Kippur. But we also saw how shiurim could interplay with trauma, eating disorders, and societal pressures around body size and image. Additionally, we noted that the way that shiurim are explained and framed matters. The language used can either lock a person into a potentially unsafe situation or empower them to eat until it is enough for them.

Next, we reviewed a selection of halakhic sources, beginning with the Mishnah, which told us to feed an ill person until they say that it is enough. We concluded with contemporary halakhic authorities. I also suggested additional framings and language to use in discussions regarding shiurim.

As we move forward, many of us – rabbis and community members – will have conversations about shiurim for Yom Kippur. When we do, let’s speak about shiurim as one option to support those not able to safely fast, also acknowledging that for some people, shiurim are not enough. Let’s emphasize that eating as usual or in greater amounts than shiurim is not halakhically problematic or a transgression for those who need to do so. Rather, when fasting on Yom Kippur is unsafe, it is holy and halakhically sanctioned to eat until it is enough.

When we change the way we speak about shiurim, we support safe observances of Yom Kippur. May we do so, until it is enough.

Addendum: Additional Guidance
In this piece, I have emphasized that shiurim should only be used when safe and sufficient. But if you are a community member who is unable to safely fast, how do you know whether shiurim are enough for you? If you are a rabbi, how can you determine who, of those unable to safely fast, is able to safely eat in shiurim, and who is not?

For community members, both self-reflection and consultation with a health professional (therapist, doctor, pharmacist, midwife, etc.) play an important role in this decision making process. Below, I offer some sample questions that you might ask.

For rabbis, I encourage you to facilitate your community members’ process in gathering information about their circumstances from people whom they know and trust. Your community members can be encouraged to engage in self-reflection and to speak to a trusted health professional for guidance.

Questions for Self-Reflection

• When I fasted a full day or tried to fast, what symptoms occurred?
• Would speaking to my health professionals be helpful, or do I already know that fasting has been unsafe for me?
• If I am not safely able to fast, would shiurim be safe and sufficient for me?
• Do I have a history of an eating disorder or trauma around food and hunger? Even if never diagnosed with an eating disorder, do I have a history of disordered eating?
• Even if shiurim could be safe and sufficient for me if I ate and/or drank at every interval, would it be very difficult for me to keep track and make sure to eat in that way?

Questions to Ask Your Health Professionals

If you aren’t sure whether fasting is safe for you, health professionals (doctor, midwife, therapist, pharmacist, etc.) who know you and your condition(s) well can be a source of important information. When speaking to a health professional, it is important to explain that fasting on Yom Kippur would involve both not eating and not drinking anything, including water. Specific questions can help answer the question of whether, if fasting is unsafe, shiurim will be safe and sufficient.

Here are some questions you might ask a health professional:

• If I were to go without food and drink (including water) for 25 hours, what might happen? Is it possible that I could be in danger? Could I experience significant or ongoing health impacts?
• If going without food and drink for 25 hours is potentially unsafe for me, could I safely either only eat or only drink? My drinking options could include liquids like smoothies as well as liquids more designed for hydration.
• Would it be safe for me to eat and/or drink small amounts with breaks of nine minutes in between?^[40]
• Is it only safe for me to eat small amounts in intervals if I eat and/or drink at almost every opportunity? What would happen if I skipped or forgot to eat some of these small amounts?
• If I drink in small amounts, which liquids should I drink – water, sports drinks, smoothies, etc., or does it not matter?
• If I spread out my eating in small amounts throughout the day, are there certain kinds of foods that I need to make sure to eat, i.e., protein sources, something to balance blood sugar, etc.?

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[1] Translation is my own. This mishnah begins by speaking about a pregnant woman. My focus in this piece is on those who cannot safely fast due to illness, disability, trauma, and more. Those reasons can be concurrent with, or separate from, pregnancy.

[2] To simplify the flow of the writing, I will often use the word ‘eat’ to refer to eating and/or drinking.

[3] This piece is specifically about Yom Kippur. While there are varying opinions about whether there is a halakhic basis to advise those who must eat on Tishah be-Av to eat in shiurim if shiurim will be safe and sufficient for them, this piece contains important language and framing that may be helpful on either day. Please note that for Tishah be-Av, a lower standard needs to be met to have a mitzvah to eat than on Yom Kippur. There is an even lower standard for what are called “minor fast days.”

[4] The term “shiurim” technically means measurements. In this context, it is used to refer to a rabbinic standard of eating or drinking in specific small quantities within a certain time period. In halakhic terms, this amount is less than a large date bulk (kotevet hagisah) of food or less than a cheekful of liquids (melo lugmav), separated by a span of time that it would take to eat half a loaf of bread (kedei akhilat pras). Eating and drinking are tracked separately. The length of time to wait between each opportunity to eat or drink varies by halakhic source. However, instructions about how to eat in shiurim often reference the opinion of waiting nine minutes. This time frame was attributed to Chatam Sofer, Mishnah Berurah, and Rav Moshe Feinstein on Halachablog, written by Rabbi Avi Zakutinsky. Several of these halakhic authorities specify how to lower the increments when needed for a person’s safety. This footnote provides a basic introduction to shiurim for those who are unfamiliar with the concept. Please note that this piece should not be understood as instructions for how to eat in shiurim.

[5] I mostly hear the language of ‘minimize your transgression’ in conversations, rather than in writing.

[6] Here, the phrasing of ‘eating as usual’ means eating in the same amounts and manner that that specific person would need to eat on a usual day. Please note that eating as usual on Yom Kippur can look different for different people. As we wrote on A Mitzvah to Eat’s answers to frequently asked questions, “Some people who need to eat as usual on Yom Kippur may be able to safely mark the day by altering the kinds of foods they eat. Others may need to eat the same kinds of foods as they usually do or to follow a specific meal plan designed by health professionals.”

[7] Halakhic texts are clear that we are concerned with a broad range of potentially unsafe circumstances. For those who are already in danger, we do not want fasting to potentially cause additional danger or to extend existing danger. We are also concerned about those who are not yet in danger but who could face worsening illness or the possibility of danger from fasting. As an example, here is Rav Eliezer Melamed‘s framing: “Permission to eat is not limited to cases of grave danger. Rather, as long as there is a chance that fasting will cause a person’s death or weaken his ability to fight off an illness that afflicts him, it is a mitzva[h] for him to eat and drink as needed.”  (Peninei Halakhah, Days of Awe, English edition 8:3) There are two important elements in his language. The first is that danger does not have to be immediate. The second is that significant impacts to one’s health is also a concern.

[8] As part of my work for this article, I created a survey and spoke to several rabbis about their perspectives on shiurim. The insights I gathered were outside the scope of this piece, but I look forward to continued conversations and writing.

[9] While I was open to interviewing people of any gender, all of the people who volunteered to speak with me were women.  

[10] Trigger warning: For those wondering about the connection between abuse and not being able to safely fast, here is a brief explanation. (Please note that abuse survivors have many different experiences.) Sometimes abusers control access to food or tie eating (or not eating) to other kinds of abuse. For those with this kind of trauma, experiences of hunger that cannot be met with unconditional access to food (like fasting) may trigger trauma symptoms that could either be dangerous or involve intense suffering. Shiurim, because of their small amounts and measured, limited access to food, can similarly be unsafe and triggering for those with trauma around food and hunger.

[11] In this piece, every person spoke to a rabbi for guidance. Of course, some people do make their own decisions. Personally, I wanted a rabbi to hear my fears about continuing to fast and to provide thoughtful and supportive guidance.

[12] After receiving advice from the first rabbi to keep trying to fast, I spoke to a different rabbi the next year, asking yet a different rabbi three years after that. In total, it took five years from when I first began asking for guidance until I received support to safely observe Yom Kippur through eating, rather than fasting. Because of this, I encourage those who receive guidance that they consider unsafe to ask a different rabbi the same year. This is not ‘rabbi shopping.’

[13] In an article entitled “From Parsha to Halakha Emor: The Affliction of Yom Kippur,” Rabbanit Debbie Zimmerman suggests that eating in shiurim is a way to observe the mitzvah of affliction (inui) on Yom Kippur. I especially appreciated this paragraph:

This also explains how someone who must eat and drink on Yom Kippur can still fulfill the mitzvah of inui, even if they don’t limit themselves to “shiurim.” Accepting God’s will that we may not fast because we must ensure our safety is also a form of inui. Interestingly, the mitzvah of safeguarding our own lives uses similar wording to the mitzvah of inui, but adds the word “me’od” – exceedingly: “v’nishmartem me’od l’nafshoteikhem,” “you shall be exceedingly careful with your lives.” (Devarim 4:15; TB Brakhot 32b; Mishneh Torah Hilkhot Rotzeakh u’Shmirat HaNefesh 11:4). One day a year we are commanded to completely submit ourselves to our spiritual side and to God, but every day, including that one day, we are commanded to be exceedingly careful with ourselves – our health and safety.

[14] For those looking for a wider overview of halakhic sources about shiurim, I recommend the article “Yom Kippur 5780, Shiur 1” from Medicalhalacha.com, published without listing the author. The section about one who is dangerously ill begins on page 5.

[15] Translation by Sarah Osborne and Peninah Engel

[16] It was believed that if a pregnant woman had a craving for food and did not satisfy it, it would put her in danger. This will be discussed in greater detail later.

[17] The halakhic sources frame one who is ill as needing to be fed or brought food. In our times, some ill people may need that, but others are able to feed themselves. While the words “we feed him” can sound like a lack of agency, particularly for one who is able to feed themselves, there’s something about this language that I like. This person who must eat and drink on Yom Kippur does not have to do so alone. There is someone there to offer support, give them food, and offer reminders that their mitzvah is to eat on Yom Kippur.

[18] Translation by Peninah Engel and Sarah Osborne.

[19] The halakhic category of holeh holds some complexity. We typically translate these words as a sick or ill person, halakhically separating between one who is in danger and one who is not in danger. Sometimes, the category of dangerously ill is segmented into one who is already dangerously ill and one who could become dangerously ill or experience significant health impacts from fasting. However, some circumstances are harder to fit neatly into these categories. Here, I will use the term holeh in my writing to mirror the language of the texts. However, when I am not referring to specific texts, I often set aside the question of what it means to be “ill” or to be in the category of holeh. Instead, in the context of fast days, I frame the holeh as “one who cannot safely fast.” 

[20] Rambam on Mishnah Yoma 8:5.

[21] Translation by Peninah Engel, with edits.

[22] Elsewhere in the Gemara (Kareitot 13a) we do encounter the idea of feeding less than a shiur to a pregnant woman who is facing danger. There is debate about whether this text is referring to Yom Kippur or a craving for forbidden foods.

[23] The William Davidson Talmud translation, with my minor edits.

[24] Peninei Halakhah, Days of Awe 8:5:2. Translation is my own.

[25] https://yahadut.org/en/shabbat-and-festivals/yom-kippur/eating-and-drinking-minimal-amounts.

[26] Tur (Orah Hayyim 618) uses language of ‘lightening the prohibition’ [that must be permitted] (להקל האיסור) regarding the use of shiurim, which has a different connotation and meaning than ‘minimizing transgression,’ as discussed earlier. He also emphasizes twice that shiurim should only be used when enough.

[27] For example, Rambam (Mishneh Torah, Shevitat Asor 2:8) does not mention shiurim, and requires eating until the person says “It is enough for me.”

[28] The section begins with a description of the ill person and the decision making process:

[Regarding] a sick person who needs to eat, if there is an expert doctor there, even if he is a non-Jew, who says that if this person is not fed it is possible that the illness will worsen on him and he will be in danger, they feed him on the doctor’s orders, and [the doctor] does not need to say that [if the person doesn’t eat] he might die. Even if the sick person says he doesn’t need [to eat], we listen to the doctor. But if the sick person says, “I need [to eat],” even if one hundred doctors say that he does not need to, we listen to the ill person. (Translation is my own.)

[29] Translation by Peninah Engel and Sarah Osborne. Emphasis is my own.

[30] Note that Rabbi Yosef Caro, author of Shulhan Arukh, describes the shiur amounts and time frames by using eggs rather than dates and bread.

[31] Arukh Ha-Shulhan, Orah Hayyim 618:15.

[32] Ibid. Translation by Peninah Engel and Sarah Osborne. Emphasis is my own.

[33] In Orah Hayyim 618:2 and 618:15, Arukh Ha-Shulhan cites tuberculosis as an example of a healing process that involves eating in increased amounts, saying that these needs should be fully met. The same halakhic reasoning should apply in other cases when eating as usual or in amounts designed by a health professional either provide stability for a chronic condition or are part of the healing process (which might require many years).

[34] In this same section, Arukh Ha-Shulhan states that shiurim are enough for most people. My perception greatly differs from that assessment. While I only have anecdotal evidence (which is also what Arukh Ha-Shulhan had, presumably), I believe that there is a sizable number of people for whom shiurim are not safe and sufficient.

[35] Rabbi Joseph B. Soloveitchick, Halakhic Man (Philadelphia: Jewish Publication Society, 1983), 35.

[36] Shevitat Asor 2:8.

[37] Here, I wrote ‘doctor’ to reflect the translation of the word ‘rofei’ in the original source. However, it is important to value the guidance of any health professional, for both mental and physical health, including therapists, dieticians/nutritionists, and midwives.

[38] Peninei Halakhah, Days of Awe 8:5.

[39] Peninei Halakhah, Days of Awe 8:5, English translation.

[40] Halakhic sources vary on the time increment, but this will give your health professional a sense of how shiurim work. Please note that it is not your health professional’s role to instruct you to eat in shiurim on Yom Kippur, but rather to give their opinion on whether shiurim could be safe and sufficient for you.